DISCUSSION
Main findings
This systematic review aimed to evaluate the research evidence of how
different lubricants could contribute in reducing the severity of
perineal trauma. Nineteen trails enrolling 5445 women were eligible for
inclusion. Our meta-analyses showed that with moderate certainty of
evidence, lubricant use reduced the incidence of second-degree perineal
laceration; and with very low to low certainty of evidence, lubricant
reduced the incidence of perineal trauma, episiotomy, and shortened the
duration of second-stage labor, but did not affect rates of intact
perineum, first-degree perineal laceration, severe perineal laceration,
postpartum hemorrhage and Apgar score. Subgroup analysis indicated that
women with obstetric gel had a shorter duration of the second-stage when
compared with liquid wax. For nulliparous women, lubricant use reduced
the incidence of perineal trauma, second-degree perineal laceration,
shortened the duration of second-stage labor, and increased the rate of
intact perineum. For multiparous women, lubricant use reduced the
incidence of perineal trauma, first- and second-degree perineal
laceration.